Safety of Dupilumab and Risk of Cutaneous T‐Cell Lymphoma in Pediatric Patients With Atopic Dermatitis: A Data‐Driven Guide to Counseling Patients and Families

Recent publications reporting increased cutaneous T-cell lymphoma (CTCL) risk with dupilumab in atopic dermatitis (AD) have sparked debate, amplified by media coverage linking dupilumab to lymphoma. These concerns have reached pediatric populations, where we observe increasing parental hesitancy about initiating dupilumab for their children. This hesitancy is particularly acute given that dupilumab was only approved for infants aged 6 months and older in 2022-the first cohort now approaching 3-4 years of exposure. Parents understandably question the long-term effects of decades of IL-4/IL-13 blockade initiated during critical immune development periods. The diagnostic overlap between AD and mycosis fungoides (the most common CTCL) complicates assessment. We examine evidence regarding dupilumab safety and CTCL risk specifically in pediatric patients, incorporating recently presented long-term open-label extension data, and provide recommendations for monitoring, distinguishing AD from CTCL, and counseling families navigating this complex topic.